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Is over-treatment riskier than breast cancer itself?

CTCA
May 21, 2014

A new report published in the Journal of the American Medical Association found that screening guidelines for breast cancer should be made on a more individualized basis to avoid over-treatment and related complications.

Mammography enables doctors to find tumors that are too small to feel. However, since the test does not determine the potential danger of a tumor, some women may undergo biopsies, surgery, radiation and/or chemotherapy for breast cancers that are not life-threatening. This has sparked debate over whether potentially unnecessary testing and treatment may be worse than breast cancer itself.

The study researched women between the ages of 40 and 70. According to the findings, for every 10,000 women, mammograms saved the lives of about five women in their 40s, 10 women in their 50s, and 42 women in their 60s.

The report also found that half of women screened for 10 years had a “false positive,” which required additional testing or a biopsy of healthy tissue. In addition, 19 percent of the cancers found during these early screenings were not life-threatening.

The concept of over-treatment is based on the idea that not all breast cancers are deadly. Some cancers never progress, researchers suspect, and some progress so slowly that the woman will probably die of something else, particularly if she is older or has other health problems.

However, there is currently no way to know whose cancer would have been fine without treatment. Because of this, many doctors believe the potential risk of additional testing and treatment is worth saving even one woman’s life.

The American Cancer Society recommends yearly mammograms starting at 40 years of age, yet some studies show a 50 percent increase in false-positives when breast detection begins at 40. The U.S. Preventive Services Task Force says women should wait until the age of 50 and repeat the test every two years.

For now, talk with your doctor about the right time for you to start mammograms. This decision will depend on your age, family history and overall health, as well as personally weighing the risks on both sides of the mammogram debate.